Some labor unions that enthusiastically backed President Barack Obama's health care overhaul are now frustrated and angry, fearful that it will jeopardize benefits for millions of their members.
Union leaders warn that unless the problem is fixed, there could be consequences for Democrats facing re-election next year.
"It makes an untruth out of what the president said _ that if you like your insurance, you could keep it," said Joe Hansen, president of the United Food and Commercial Workers International Union. "That is not going to be true for millions of workers now."
The problem lies in the unique multiemployer health plans that cover unionized workers in retail, construction, transportation and other industries with seasonal or temporary employment. Known as Taft-Hartley plans, they are jointly administered by unions and smaller employers that pool resources to offer more than 20 million workers and family members continuous coverage, even during times of unemployment.
The union plans were already more costly to run than traditional single-employer health plans.
But Obama's Affordable Care Act has added to that cost _ for the unions' and other plans _ by requiring health plans to cover dependents up to age 26, eliminate annual or lifetime coverage limits and extend coverage to people with pre-existing conditions.
"We're concerned that employers will be increasingly tempted to drop coverage through our plans and let our members fend for themselves on the health exchanges," said David Treanor, director of health care initiatives at the Operating Engineers union.
Workers seeking coverage in the state-based marketplaces, known as exchanges, can qualify for subsidies, determined by a sliding scale based on income. By contrast, the new law does not allow workers in the union plans to receive similar subsidies.
Bob Laszewski, a health care industry consultant, said the real fear among unions is that "a lot of these labor contracts are very expensive, and now employers are going to have an alternative to very expensive labor health benefits."